Dorit Kagy Baxter on October 22, 2015

Three Keys for Success in Today's Payer Market Highlighted at Forum

Last week I had the pleasure of attending my very first NaviNet Customer Forum. The forum, NaviNet’s 13th, was held over two and a half days in Boston and is designed to bring together today’s leading industry thought leaders, our top health plan customers, providers and clinical staff who use NaviNet’s applications, and healthcare ecosystem partners to address top industry issues and trends. This year we were excited to welcome over 20 health plans. We also enjoyed insights from industry thought leaders that included Dr. Anthony Coletta of Tandigm Health, John Moore of Chilmark Research, Daniel Hilferty of Independence Blue Cross, and Aneesh Chopra, the first and former Chief Technology Officer of the United States.


Coming from a large payer, I know first-hand the dramatic changes the ACA has had on today’s payer market, so I was particularly inspired by how different players in healthcare— all with different views and vantage points—are boldly taking on the challenge of producing better outcomes, reducing the cost of care and driving improved provider and patient satisfaction.  Throughout the forum, if there was one constant thread linked to this challenge, it was we need to be open. To be more specific, if we want to be successful at improving outcomes and costs, we must remain open to disruption in the market, open to collaboration across stakeholders, and open to innovation that is meaningful.

Open to Disruption:

High-deductible plans, risk-based economic models, the ACA, value-based payment models… these have all created significant disruption in the industry.  And we heard from payers who were creating their own disruption in the market, disruption that is driving higher patient engagement and significant operational cost reductions. We also heard about new models for engaging the consumer and driving member retention and provider satisfaction, such as SpendWell Health’s model, which allows consumers to make more informed decisions and “shop” and pay for their portion of care before ever entering a provider’s office.

Open to Collaboration:

Despite how competitive the payer landscape has become, our payer speakers all stressed the importance of learning from one another and leveraging business partnerships across the greater healthcare system.  Taking advantage of existing and emerging standards to reduce barriers and attain interoperability is key. Although significant work remains to fill existing gaps in data exchange, our payer customers and our partners are ready to experiment, influence and drive the change necessary to get there. As our President and CEO Frank Ingari said, “to succeed in value-based care the 'network' is the lever for success."


Open to Innovation:

Multiple speakers at the forum reminded us that technology is no longer a tactical implementation and is instead a strategic imperative.  Health plans and providers alike must be bold and nimble enough to quickly evaluate and adopt best-in-class solutions, especially those that facilitate efficient and effective exchange of data and information at the point of care. Aneesh Chopra also reminded us that we "need an operational culture that enables innovation... [and to] give freedom to innovate." We heard and saw examples of this, including demos of our own NaviNet Open applications and of the possibilities of FHIR technology.

More Insights:

From a first-timer’s perspective, I found NaviNet’s Customer Forum to be a powerful “meeting of the minds” and there were many more valuable and more detailed insights into disruption, collaboration, and innovation that don’t quite fit into one blog post.  If you weren’t able to make it and are interested hearing what else was shared by the forum’s thought leaders, join me and Chuck Digate, our Senior Vice President of Sales and Marketing and Chief Commercial Officer, for our upcoming webinar: “2015 NaviNet Forum Recap: Disruption. Collaboration. Innovation.” 


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